What America’s withdrawal from the WHO means for global health.
For decades, the United States has had considerable influence in determining the direction of global health policies and programs. President Donald Trump has issued three executive orders against him First day in the office This could mark the end of that era, health policy experts said.
Trump ordering to the pick up From the WHO, it means the US will likely not be at the table when the WHO’s executive board meets next February. WHO is formed by its members: 194 countries that agree on health priorities and how to share critical information, treatments and vaccines during international emergencies. With America gone, it will cede power to others.
“It’s silly,” said Kenneth Bernard, a visiting fellow at Stanford University’s Hoover Institution who served as the top biodefense official during the George W. Bush administration. Withdrawal from the WHO would leave a vacuum of global health leadership to be filled by China, which is clearly not in US interests, he said.
The executive has ordered the withdrawal of the WHO and the re-evaluation of the United States Approach to international aid Citing the World Health Organization’s “mishandling of the COVID-19 pandemic,” US aid serves to “disrupt world peace.” In practice, they echo established priorities. Project 2025“Leadership”, a Conservative policy design From the Heritage Foundation.
The 922-page report says the US should be ready to withdraw from the World Health Organization, citing the “spectacular failure” and recommending changes to the State Department’s international aid. “The Biden administration has revamped the agency as a global platform for pursuing a divisive political and cultural agenda abroad that promotes abortion, climate extremism, gender racism and interventionism,” it says.
As one of the World Health Organization’s largest funders — through international and national agencies such as the World Health Organization and the US Agency for International Development — a U.S. move back could undermine efforts to provide life-saving health services and fight deadly epidemics, especially Low-income countries do not have the means to do it alone.
“Not only does this make Americans less safe, it makes citizens of other countries less safe,” said Tom Bolicki, director of global health at the Council on Foreign Relations.
“The US cannot insulate itself from global health threats,” he said, referring to policies that bar travelers from countries with disease outbreaks. “Most of them Evidence around travel restrictions It suggests that they provide a false sense of security and distract countries from taking steps they should take domestically to ensure their security.
Less than 1%
Technically, countries cannot withdraw from the WHO a year earlier as long as there is official notification. But Trump’s executive order mentions a 2020 termination notice. If Congress or people He pushes backthe administration could argue that it has been over a year.
Trump in 2016 He froze funding to the World Health Organization in 2020, a move that does not require congressional approval. US contributions to the agency have been low. 163 million dollars Falling behind Germany and the Gates Foundation in the first year of Covid. Former President Joe Biden reinstated US membership and dues. In 2023, the country committed to WHO. 481 million dollars.
In the year By 2024, Suri Moon, associate director of the Global Health Center at the Geneva Graduate Institute, said the Biden administration had paid off. I owe two years Early for 2024-25, which covers some of this year’s payments.
“Unduly burdensome fees” were cited in the executive order as the reason for the WHO’s withdrawal. Countries’ contributions are a percentage of their gross domestic product, meaning that as the world’s richest country, the United States generally pays more than other countries.
Funding for WHO is about 4% of US funding. Budget for global healthWhich in turn is 0.1% of US federal spending every year. At around $3.4 billion, WHO’s overall budget is about one-third of the Centers for Disease Control and Prevention’s budget, which received $9.3 billion in core funding by 2023.
of World Health Organization money Programs to help prevent and treat polio, tuberculosis, HIV, malaria, measles and other diseases, especially in countries that struggle to provide local health care. The organization responds to immediate health emergencies in conflict zones, including areas where the U.S. government does not operate — in parts of Gaza, Sudan, and the Democratic Republic of Congo, among others.
In the year In January 2020, the World Health Organization announced the threat of the COVID pandemic to the world by sounding the highest alarm: a public health emergency of global concern. Over the next two years, he developed diagnostic tests and potential cures for Covid, regularly updated the public, and advised countries on measures to keep citizens safe.
Experts have mentioned wrong actions in the agency, but Several analyzes show Those internal problems mean the United States has one of the world’s highest death rates from Covid. “All countries have accepted the World Health Organization’s warning of a public health emergency of international concern on January 30,” Bolicki said. “South Korea, Taiwan and others responded strongly to that – the US did not.”
“It’s a red herring.”
However, Trump’s executive order accused the WHO of “mishandling” the pandemic and “failing to take urgently needed reforms.” In fact, the World Health Organization has made some changes in bureaucratic processes that include input from countries. Last year, for example, the company It has undergone many improvements to the regulations on health emergencies. These include provisions regarding transparent reporting and integrated financing.
“If the Trump administration tries to make a different change for a year and they get frustrated, I might find the reform line credible,” Moon said. “But to me, it’s a red herring.”
“I don’t buy the explanations,” Bernard said. “This is not a financial issue,” he added. “There is no reason to leave the World Health Organization, including our problems with China.”
Trump has accused China of complicity in the WHO’s failure to clearly investigate the origins of Covid, citing “improper political influence” in the executive order.
“The World Health Organization has shamefully covered up the Chinese Communist Party’s every move,” Trump said. Video Posted on social media in 2023.
In many cases, the World Health Organization He asked for clarity From China. The agency has no legal authority to compel China or any other country to comply. This fact belies Trump’s warning that the pandemic agreement in World Health Organization negotiations will undermine US sovereignty. Instead, the agreement aims to outline how countries can best cooperate against the pandemic.
Trump’s executive order calls for the United States to “cease negotiations” on the pandemic agreement. This means the pharmaceutical industry could lose one of its staunchest defenders as negotiations move forward.
In the negotiations so far, the US and the European Union have sided with the lobby Pharmaceutical industry To enforce strict patent rights on drugs and vaccines. They have Opposing efforts To include licensing agreements that allow many companies from middle-income countries in Asia, Africa and Latin America to produce drugs and vaccines for emergency supplies. A A study published in Natural Medicine It is estimated that by 2021, more than one million lives would be saved if Covid vaccines were available worldwide.
“Once the US is gone – for better or for worse – the pressure on certain places will be reduced,” Moon said. “In pandemic agreement negotiations, we see opposition to more public health-oriented intellectual property approaches.”
Ayoade Alakija, chair of the African Union Vaccine Supply Alliance, said: “This is a time of geopolitical change because the US is losing itself more and more relevance. Alakija said emerging economies in Asia and Africa can now add more money to the WHO, change policies and set agendas that have previously been opposed by European countries fighting the US and Ukraine wars. “Power is shifting,” Alakija said. “Maybe this will give us a more fair and just world in the long run.”
Echo of the 2025 project
In the near future, however, the World Health Organization will not be able to fully recover its losses, Moon said. Funds from the US account for 15 percent of the budget. With Trump Executive order The lack of funding, which has halted international aid for 90 days, could prevent many people from receiving life-saving treatment for HIV, malaria and other diseases.
Another loss is the scientific collaboration hosted by the World Health Organization and about 70 centers at American institutions such as Columbia University and Johns Hopkins University. Through these networks, scientists share discoveries despite political strife between countries.
A The third executive order Directs the Secretary of State to ensure that the Department’s programs are “consistent with America’s first foreign policy.” It follows an order to temporarily freeze international aid while it evaluates “consistency with US foreign policy.” That order said U.S. aid served “to disturb the peace of the world by promoting ideas contrary to harmony and stable relations in foreign countries.”
These and executive orders on climate policies follow policy agendas It is described in Project 2025. Although Trump and his new administration are serving themselves from the Heritage Foundation playbook CBS News reviewed It noted that 38 of the named primary authors have career histories and at least 28 worked in the first Trump administration.
He was one of its chief architects. Russell VoughtHe served as director of the Office of Management and Budget during Trump’s first term and was nominated for re-election. A number of contributors to Project 2025 from the America First Legal Foundation, a group led by Trump adviser Stephen Miller, complained about “crooked corporations.”
Project 2025 recommends cutting international aid to programs and organizations focused on climate change and reproductive health care, and directing resources to “strengthen the fundamentals of the free market,” cut taxes and regulate businesses on a path to economic stability.
Many experts say the executive orders appear to be more about ideology than strategic positioning.
The White House did not respond to questions about the executive orders on global health. “We will direct you to the White House,” a USAID spokesperson wrote in response to the executive order, which said US aid was “undermining world peace.”
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